How is medical abortion performed? Medical termination of pregnancy - what, when and how is pharmacological abortion performed? 2 medication interruptions

The most gentle way to perform an abortion is medical termination of pregnancy. It is practically safe for the health and emotional state of a woman. To carry it out, drugs are used that provoke the expulsion of the fertilized egg.

What is medical abortion?

The term “pharmabort” usually means the artificial termination of an ongoing pregnancy using medications. The method completely eliminates surgical intervention. During this procedure, the patient takes pills in the presence of a doctor. Under the influence of the components of this drug, the death of the embryo occurs. This completes the first stage of medical abortion.

After a certain time, the woman takes another drug. Its components provoke increased contractile activity of the uterine myometrium. As a result, the rejected fertilized egg is expelled and an abortion occurs. This procedure has a number of advantages relative to other methods (curettage,):

no trauma to the uterus;
rapid restoration of the menstrual cycle;
low risk of complications;
does not require anesthesia.

Medical termination of pregnancy - timing

When answering a woman’s question about how long a medical termination of pregnancy can be carried out, doctors say 6-7 weeks. Pharmaboration can be carried out no later than 42–49 days from the moment when the first day of the last menstruation was noted. At the same time, the effectiveness of this procedure decreases over time, and the likelihood of complications increases.

Doctors say the optimal time for medical abortion is up to 4 weeks. The fertilized egg does not have time to securely attach itself to the uterine wall, so it is rejected and released better and faster. In addition, the hormonal background has not yet been fully established, the restructuring of the body has not been completed, so it will be easier for it to return to its previous state, before pregnancy.

Medical termination of pregnancy - contraindications

The main indication for such an abortion is the desire of the woman herself. However, not all pregnant women and not all cases can undergo a medical abortion. In addition to the time frame indicated above, there are other contraindications to the implementation of medical abortion:

history of allergic reactions to medications;
liver failure;
adrenal insufficiency;
pathological bleeding;
active inflammatory process in a woman’s body;
pulmonary tuberculosis;
suspicions of;
oncological processes;
lactation process;
administering corticosteroid therapy;
disorders of the blood coagulation system.

How does medical abortion occur?

Talking about how the pharmabort is performed, the doctor explains the stages of the procedure. Beforehand, a woman needs to undergo a short examination, which is prescribed on the day of treatment:

Ultrasound of the uterus;
microflora smear;
blood test for syphilis.

After receiving the results, an exact time is assigned when a medical abortion will be performed, the timing of which is indicated above. During the second visit, the doctor talks with the woman again, clarifies the seriousness of her intentions, and whether she has changed her mind. The patient is then given the drug, which she drinks in the presence of a doctor. Under the influence of the drug, endometrial growth stops, and the muscle layer begins to contract. The woman is observed for 2-3 hours, after which she leaves the clinic.

The patient is given a tablet of another drug that stimulates uterine contractions. It is taken after 36–48 hours, as directed by the doctor. Under the influence of the drug, the dead embryo is expelled out. Only after this is the medical abortion considered complete. A woman records bloody discharge.

Medical termination of pregnancy - drugs

A woman, even if she wants, cannot carry out a pharmaceutical abortion on her own - pills for its implementation are not sold in the pharmacy chain. When performing a medical abortion, drugs are used with a high content of hormones, so they are issued by a doctor in a medical facility. To carry out medical abortion, the following groups of drugs are used:

Antigestagens– suppress the effect of natural gestagens at the receptor level. A representative of this group is Mifepristone, Mifegin. For pharmaboration, 600 mg of the drug is used.
Prostaglandins– enhance the contractility of the uterine myometrium. Most often from this group they use Mirolut. 400 mg of the drug is prescribed. Taken 36–48 hours after the antigestagen.

How do you know that the pharma abortion was successful?

Complications are possible with any medical procedure, so women often ask doctors how to understand that a medical abortion was unsuccessful. In order to exclude possible violations, after 14 days the woman must visit the clinic and undergo a control ultrasound. The doctor must make sure that the fertilized egg and its remains have completely left the uterine cavity. They examine the organ itself, determining its size. In a woman, the doctor clarifies the nature of the discharge, the presence and severity of pain. Often, after a pharma abortion, the test is positive - this is due to altered hormonal levels.

Menstruation after pharmaabortion

Normally, menstruation comes after pharmaabortion within 28–30 days. Taking abortifacients has virtually no effect on a woman’s hormonal background, so menstruation is not disrupted. However, in some cases there is a change in the volume of discharge: it can be scanty or excessively abundant. Thus, a small amount of discharge after medical termination of pregnancy may be due to:

Small dilatation of the cervix during an abortion - fragments of the fetus cannot come out normally, accumulating in the uterine cavity.
Incomplete abortion - the fertilized egg is not completely rejected, and the fetus continues to develop.

Bleeding is observed within 2-3 days after pharmaabortion. Normally, it lasts up to 10–14 days. The fertilized egg separates in parts, which is why the discharge lasts a long time. Their volume exceeds the number of menstrual ones. You need to be careful about the volume, making sure that they do not go into . Signs of such a complication are:

a large amount of blood released from the vagina - in half an hour the sanitary pad (“maxi”) is completely saturated;
pain in the lower abdomen;
dizziness;
pale skin;
increase in the number of heart contractions;
decrease in blood pressure.

Sex after pharmaboration

After the pharmaabortion has been carried out, the doctor explains to the woman what not to do and what rules to follow. At the same time, special attention is paid to intimate life. Doctors do not recommend that women have sexual intercourse until the bleeding stops. Otherwise, there is a high risk of infection of the reproductive system. On average, the period of abstinence should be 2-3 weeks from the moment of abortion.

Pregnancy after pharmaceutical abortion

A properly performed pharmaceutical abortion does not affect reproductive function. after such an abortion, pregnancy is possible already a month later, in the next menstrual cycle. Considering this fact, doctors strongly recommend protection. Often women regret what they did and want to get pregnant again. In addition, there are cases when the termination was carried out for medical reasons, so the woman wants to quickly become pregnant again.

The reproductive system needs time to recover, so you need to refrain from planning a pregnancy for 6 months from the moment the medical termination of pregnancy was carried out. During this period, doctors recommend using. In this case, it is better to give preference to mechanical ones (condom), since the use of hormonal agents can affect the hormonal background.

The consequences of medical termination of pregnancy are less dangerous than surgical ones, but in the absence of qualified assistance they can lead to infertility and even death. Taking pills is not difficult, however, despite the apparent simplicity of the procedure, it causes serious changes in the body: a large dose of hormones affects the reproductive system and disrupts the natural processes of preparation for bearing a fetus.

Vomit

This complication develops in approximately 44% of women when taking misoprostol orally, and in 31% when taking intravaginal misoprostol. Studies also confirm that the frequency of vomiting is influenced by the interval between taking a hormonal drug (Mifepristone) and a prostaglandin (Misoprostol). The likelihood of this symptom is lower if the interval is 7-8 hours than with a daily break.

Nausea

This symptom is more common than other gastrointestinal disorders during medical abortion. It has not been fully established what exactly it is caused by: exposure to drugs or termination of pregnancy.

However, a trend has been identified in which nausea is more pronounced with a high dose of Misoprostol (a prostaglandin), rapid administration and a gestational age of 6-7 weeks. If vomiting occurs, you must inform your doctor. You may need to take the pills again.

Allergy

Allergic reactions as a consequence of medical abortion can develop to the components of any of the drugs taken. Most often it is a rash or hives. Severe manifestations, such as Quincke's edema and breathing problems, occur extremely rarely. To avoid this complication, after taking medications you should stay in a medical facility (clinic) for at least a few hours.

Diarrhea

Stool disorders develop in approximately 36% of women when taking Misoprostol orally and in 18% when taking Misoprostol intravaginally. The symptom can have varying degrees of severity. The effectiveness of taking antidiarrheals in such cases has not been proven. Diarrhea usually stops on its own after a few hours.

Severe abdominal pain

This symptom is caused by spasm of the muscles of the uterus, which is part of the mechanism of action of the hormonal drug. It is observed in 96% of women and is considered normal. The severity of pain can vary: from mild to unbearable. The symptom begins to increase rapidly 30-50 minutes after taking Misoprostol and most often goes away after the abortion is completed. There is a tendency that the shorter the pregnancy, the easier the pain.

To eliminate it, non-steroidal anti-inflammatory drugs (Ibuprofen, Naproxen) are used, and in severe cases, narcotic painkillers (Codeine, Oxycodone).

Convulsions

Appear approximately 1.5-3 hours after taking Misoprostol. Most often localized in the groin area. They subside after the abortion is completed. A warm heating pad can be used to reduce pain.

All of the above complications do not require special treatment and most often go away on their own after the abortion is completed. When they are severe, symptomatic remedies are used.

Medium-term consequences and complications

Medium-term effects occur within a few weeks of medical abortion.

Bleeding

This symptom appears early, some time after taking the pills. If the bleeding volume corresponds to menstrual bleeding (no more than 1-2 pads per hour), lasts 7-14 days and gradually decreases, then there is no cause for concern - this is not a complication, but a normal process.

In some cases, women notice discharge for up to 30 days, but it is spotting and is not accompanied by pain or other symptoms. If the bleeding is heavy (2-3 or more pads per hour), prolonged and/or accompanied by pain, then you must immediately inform your doctor. This complication is rare and develops against the background of incomplete abortion or infection.

The longer the pregnancy, the higher the risk of abnormal bleeding. In 0.4% of cases, blood transfusion is performed, in 2.6% - suction curettage. Without timely medical assistance, death cannot be ruled out.

Continuing pregnancy or incomplete termination

In 1-4% of cases, the fertilized egg is not expelled from the uterus or is not completely expelled. This can happen for several reasons: the dose of the drug is incorrectly calculated, the timing of the procedure is too late, there are hormonal disorders or inflammatory processes in the woman’s body.

Such consequences after medical termination of pregnancy are accompanied by prolonged and undiminished bleeding, nagging or cramping pain in the lower abdomen, increased temperature, and fever. You cannot cope with them on your own; hemostatic drugs will not help.

An ultrasound and follow-up are required. If this is not done, then in the event of an incomplete abortion, the remnants of the fetal egg will lead to the spread of infection, general blood poisoning and death. If the pregnancy continues to develop, then the risk of having a child with serious malformations is high.

Pain in the lower abdomen

Normally, cramps in the uterus gradually disappear after the abortion is completed. If the pain continues, this may be a sign of infection or incomplete termination of pregnancy. This symptom requires examination by a gynecologist and ultrasound.

Headaches and dizziness

These consequences of medical abortion develop in 20% of women. As a rule, the cause is a large loss of blood. Weakness, decreased blood pressure, and lightheadedness are also observed.

If dizziness is accompanied by bleeding, then the help of a doctor is necessary. In another case, you can take an analgesic, rest more often, and change your body position gradually.

Long-term effects and complications

Long-term consequences of medical abortion are rare but most difficult to treat. They appear after several months and even years.

Menstrual irregularities

If menstruation began on time (counting from the date of abortion) or was delayed by 7-10 days, this is a sign that the reproductive and endocrine systems have recovered. About 10-15% of women note that in the first few cycles, menstruation is more painful and heavy, but soon becomes the same as before.

A complication will be indicated by a delay of more than 40 days or heavy periods, accompanied by cramping intense pain, fever, and deterioration in general well-being.

In the first case, either a re-occurrence of pregnancy is possible (this happens already 2 weeks after an abortion), or a disruption in the functioning of the ovaries. It is necessary to consult a doctor, he will determine the cause and prescribe the necessary procedures. Oral contraceptives are often used to restore hormonal levels.

If your periods are very heavy, with severe pain and a rise in temperature, then perhaps particles of the fertilized egg remain in the uterus and/or an infection has developed.

After a doctor’s examination and ultrasound, curettage is performed and antibiotics are prescribed.

Infectious and inflammatory diseases

They develop after a medical abortion as an exacerbation of chronic forms or due to remaining particles of the fertilized egg. If a woman had hidden, sluggish infectious and inflammatory processes (salpingitis, gonorrhea, etc.) before the abortion, then after the abortion procedure they may begin to progress.

This is manifested by pain in the lower abdomen, discharge with an unpleasant odor and a greenish color, purulent impurities, and increased temperature. After laboratory diagnosis, the doctor prescribes antibiotics, most often in a hospital setting.

Infertility

The causes of this serious consequence are hormonal disorders or inflammatory diseases of the uterus and appendages.

In the first case, the balance of male and female sex hormones is disrupted, as a result of which the process of fertilization of the egg and its attachment to the wall of the uterus is hampered.

Inflammatory processes can lead to the formation of adhesions and narrowing of the lumen of the fallopian tubes. This prevents the egg from moving to the uterus.

Changes in emotional state, character

Sometimes hormonal imbalance and the abortion procedure itself affect the characteristics of a woman’s psyche. She may become overly irritable, aggressive or whiny, depressed, lethargic.

At first, such reactions are observed only in difficult situations, for example, during or after a quarrel. But soon they become total, arising without external causes.

To eliminate the problem, you need to see a doctor: a psychiatrist or psychotherapist, or consult a psychologist.

Medical abortion and its consequences are still being studied. Research confirms that the earlier the abortion procedure is performed, the lower the risk of complications.

The most common among them are bleeding, pain in the lower abdomen, and infection. The consequences are associated with hormonal disorders and the risk of incomplete release of the fertilized egg. Disruptions in the menstrual cycle, development of inflammation, and infertility may occur.

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Medical abortion is the safest method of ending a pregnancy. Its essence lies in the use of special medications that provoke a miscarriage. Due to the absence of surgical intervention, a gentle effect on the body is ensured.

Price for medical abortion

Dates

Medical abortion is only permitted up to 6 weeks of pregnancy. The use of drugs to terminate a pregnancy later in life can have serious consequences for a woman's health. The danger of medical abortion for periods of more than 6 weeks is due to the fact that every week the fertilized egg grows and becomes more firmly fixed in the uterine cavity, and in addition, blood vessels begin to form. Using drugs later than 6 weeks can lead to incomplete removal of the fertilized egg, severe bleeding or the development of an inflammatory process.

Benefits of medical abortion

Medical abortion is the most acceptable method of ending a pregnancy due to a number of advantages:

High efficiency (up to 98-99%);
There is no risk of injury to the uterus, as with surgical abortion;
Minimal impact on health;
Simplicity and ease of implementation;
There is no need for anesthesia.

Stages of implementation

Termination of pregnancy by medication is carried out in two stages. After the woman passes all the tests and undergoes the necessary examinations, the doctor sets a date for the procedure. On the appointed day, the woman takes the first tablet under the supervision of a doctor, after which she remains in the medical facility for another 1-2 hours.

This precaution is necessary in case of an allergic reaction or other complications. After taking the first drug, the fertilized egg detaches from the wall of the uterus, which causes its development to stop.

After 36-48 hours, the second stage of medical abortion begins, during which the woman drinks two more pills. They must also be taken under the supervision of a doctor. After taking the pills, the woman also remains under the supervision of a doctor for 1-2 hours. After some time, the woman begins to bleed, similar to menstruation.

This occurs due to the action of the drug, which causes contractions of the uterus. Thanks to this, the fertilized egg comes out of the uterine cavity. Bleeding lasts an average of 7-10 days, with spotting gradually decreasing.

After 10-14 days, the doctor schedules another appointment for a control ultrasound. During the examination, the gynecologist evaluates the condition of the uterus, as well as the effectiveness of the interruption. If during an ultrasound examination remains of the fertilized egg are detected, the woman is referred for surgical curettage.

Recovery period

Every woman’s body is different, so everyone’s recovery period is different. The time it takes for the body to return to normal largely depends on the woman’s age, general health, and hormonal levels.

Compliance with medical recommendations and timely attendance at a follow-up ultrasound play an important role in the recovery of the body. To make the recovery process faster, and also to reduce the risk of complications after a medical abortion, a woman should follow several rules for 2-3 weeks:

Avoid physical activity and sports training;
Carefully observe intimate hygiene;
Do not use tampons;
Avoid sexual activity;
Avoid douching;
Avoid alcoholic drinks, fatty and fried foods, and unhealthy foods;
Take vitamins or other medications prescribed by your doctor.

Very often he prescribes contraceptive drugs to the woman, which begin on the day of the abortion. This helps speed up the body's recovery and avoid re-pregnancy. Complete restoration of the body occurs when a woman’s menstrual cycle and hormonal levels return to normal.

How often can you have a medical abortion?

Repeated application is possible six months after the previous one. Such deadlines are set based on the average time it takes the body to recover after an abortion. If a medical abortion is performed again before full recovery from the previous one, there is a huge risk to the woman’s health.

In such cases, various complications may arise, such as:

Long-term menstrual irregularities;
Hormonal disbalance;
Endometriosis;
Growth of benign formations (for example, fibroids);
The appearance of cancer (for example, breast cancer).

Since each woman’s body recovers according to an individual schedule, this must be taken into account when performing a repeat abortion. To make sure that the recovery was successful, you should take blood tests for hormones (FSH, LH, estradiol, prolactin, progesterone), and also closely monitor the menstrual cycle. And in order to avoid a repeat procedure for terminating a pregnancy, it is necessary to choose an effective method of contraception.

Contraindications
Medical abortion has a number of contraindications, in which its use is dangerous for the health and life of the woman:
Ectopic pregnancy (the use of abortion drugs during an ectopic pregnancy can lead to rupture of the fallopian tubes);
Pregnancy period is more than 6 weeks;
Acute inflammatory processes;
Large fibroids;
Lactation period;
If less than 6 months have passed since the previous abortion;
Individual intolerance to the components of the drug used to terminate pregnancy;

Features of medical abortion

Medical abortion (medabortion) is a method of terminating pregnancy with the help of medications, without artificially dilating the cervix and curettage of its cavity. A miscarriage occurs. Unlike surgical abortion, medical abortion is a paid service for all Russian women, regardless of whether they have compulsory health insurance or not. You need to at least pay for the expensive medications needed for a miscarriage to occur.

But even despite this, abortion in the early stages with pills (medabortion) is becoming more and more popular, better known among Russian women and more accessible. Now this service is available in many city antenatal clinics. And private clinics generally offer a full service with the provision of a separate room into which you can bring a relative or friend.

Description of the procedure and drugs

How does a medical abortion go, how does a miscarriage happen? These are important questions. The doctor performing the procedure must inform his patient about the matter. She will be taking two medications. The first Mifepristone. This is a progesterone antagonist, in medical terms. It blocks the ability of progesterone, a very important hormone for expectant mothers, to perform its functions. The uterus becomes more excitable after taking it, and detachment of the membranes begins.

Mifepristone was invented more than 30 years ago. It showed a pretty good result, although far from 100% effective. But side effects were minimal. However, it was necessary to increase the effectiveness, and another drug was added to Mifepristone in order to avoid the unpleasant consequences of medical abortion in the form of incomplete detachment of the fertilized egg and its membranes. The regimen included a synthetic prostaglandin. It is taken 36-48 hours after Mifepristone. Although some women have a miscarriage after taking Mifepristone. However, the second drug is necessary to ensure that the uterus is completely cleansed. It is interconnected with the first. Mifepristone, by lowering progesterone, leads to good “susceptibility” of prostaglandin. And he, in turn, quickly starts the process of expulsion of the fertilized egg. Most women say that after taking prostaglandin, within 15-20 minutes, after a strong spasm, they noticed a detached fertilized egg.

Thus, using this regimen, the effectiveness of medical abortion has increased to 95 percent or higher. Doctors from dozens of countries have adopted the experience of this procedure and thus preserved the health of their patients. After all, as we said earlier, surgical abortion is always much more dangerous in terms of complications.

The downside is that medical abortion has a limited time frame. It is done only up to 6 obstetric weeks of pregnancy. Which is approximately equal to two weeks of delay in menstruation. Many women in such a short time cannot understand what is wrong. Especially those whose menstrual cycle is irregular. It is interesting that abroad Mifepristone and prostaglandins are allowed to be used even during slightly longer periods of pregnancy. But in Russia it’s like that.

"Mifepristone", and other drugs with the same active ingredient, are used for artificial childbirth under medical conditions. indications, but according to a different scheme. And also to speed up the preparation of the genital tract for childbirth, preparing the cervix for surgical manipulations (for example, surgical abortion). With its help, uterine fibroids are treated conservatively.

Mifepristone is also well known as an emergency contraceptive. It is freely sold in pharmacies. Just the dosage of one tablet needed to prevent pregnancy is 10 mg. And to terminate a pregnancy you need a minimum of 200 mg. And according to the new standards - 600 mg. Emergency contraception is quite safe, but not entirely harmless to the body. It is much more correct to take medications for regular, planned contraception, so as not to cause hormonal imbalance in the body.

But we will return to the issue of abortion. Preparations for it are not sold in pharmacies; they are given by gynecologists to patients who have an intrauterine pregnancy within the period permitted for abortion and who do not have acute inflammatory diseases or other contraindications to the procedure. After signing the consent papers.

What to prepare for when terminating a pregnancy using medication

After taking the drugs, severe nausea, vomiting, and weakness may occur. Many women's body temperature rises, and, most importantly, quite severe pain appears, very similar to labor pains. Usually, pain after a medical abortion stops with the release of the fertilized egg from the uterus, but nevertheless causes a lot of anxiety. Therefore, if your abortion will take place at home, outside of the clinic, you need to ask your doctor about pain relief. What drug, in what quantity and at what stage of the abortion can be taken.

It happens that your stomach hurts after a medical abortion, in this case you can take an analgesic or antispasmodic. Or any other drug that you are used to taking for menstrual or other pain.

Bleeding after a medical abortion almost always occurs after taking a prostaglandin. And lasts up to 10-14 days. The total blood loss is comparable to heavy menstruation. If the bleeding is even more intense or the discharge after a medical abortion persists for more than 14 days, this is a reason to suspect an uninterrupted pregnancy, a developing or frozen fertilized egg, or remnants of membranes in the uterus. At the same time, after a medical abortion, clots do not always mean this fact. You should pay attention to this if the size of the clots exceeds 2 cm and there are too many of them. This may indicate excessive blood loss, threatening iron deficiency anemia.

To make sure everything is in order, you need to do an ultrasound of the uterus. And if the results reveal an incomplete abortion, then you will have to endure more vacuum aspiration. Otherwise, there is a risk of acute endometritis and even blood poisoning.

At the same time, some clinics use slightly different procedure schemes. They almost immediately do a control ultrasound, and if, according to its results, the uterus is not completely cleared, an additional “Oxytocin” or a drug with a similar effect is prescribed. This in most cases helps to avoid vacuum aspiration or instrumental abortion. These are the potential complications a medical abortion can cause.

All that remains is to deal with the menstrual cycle. When it is restored, ovulation will occur, will it be possible to get pregnant again, and is it necessary to prepare for this event? Sex after medical abortion is permitted after the complete cessation of bloody (including brown) vaginal discharge. Ovulation can occur in the same cycle, so contraception must be used. You may not even be interested in when menstruation usually begins after a medical abortion, but this happens 28-35 days after an artificially induced miscarriage, contraceptives can and should be started to be used immediately. This could be an oral contraceptive, an intrauterine device, a condom, or a spermicide.

If you get pregnant immediately after a medical abortion, you don’t have to worry, the medications taken will not have a negative effect on the child. By then they will be completely eliminated from the body. But it’s better, of course, to plan your pregnancy. At a minimum, check the condition of the cervix and cavity, take gynecological smears, including for sexually transmitted infections. A more in-depth examination, not only from a gynecologist, but also from an endocrinologist, urologist, geneticist and other specialists, is carried out in case of infertility and the presence of any negative symptoms or chronic diseases.

Medical termination of pregnancy (pharmabortion) is not a method of birth control, but a serious medical procedure that can lead to various kinds of complications. Its essence lies in the fact that a woman must take hormonal pills at a set time to perform a medical abortion and provoke the expulsion of the fertilized egg from the uterine cavity.

According to WHO, such an abortion is recognized as the most gentle method, but it does not always give a guaranteed result. As the gestational age increases, the effectiveness of the procedure decreases significantly.

If a woman wishes to terminate a pregnancy, preference is always given to the most effective methods - medication, or (for example, curettage is ideal in the presence of a placental polyp).

Can I have a medical abortion at 7 weeks, 8 weeks or later? The best option is 14 days after the delay. The reason is that after 6 weeks the fertilized egg is already quite well attached to the wall of the uterus, so the likelihood of its preservation increases. For example, if a medical abortion is performed at 8 weeks, its effectiveness rarely exceeds 88%.

Contraindications and indications

There are no strict indications for medical abortion. The woman must decide for herself whether to continue or terminate the pregnancy.

Relative medical indications for its interruption are:

diseases that threaten the full development of the baby;
severe genetic, somatic, infectious diseases;
taking medications that can cause deformities and disrupt the full development of the fetus.

Social indications:

minor age;
rape;
absence of husband;
disability I or II in an existing child;
serving time in prison.

With such a fairly serious procedure as abortion, the main contraindications to terminating a pregnancy with the help of medications will be:

allergy to drugs used for abortion;
fibroma or;
severe renal or liver failure;
Availability ;
diseases of the blood coagulation system;
anemia;
taking blood thinners;
high blood pressure, etc.

What is the procedure

In the usual understanding, medical termination of pregnancy is not like an abortion: a woman comes to the clinic, takes pills under the guidance of a doctor, and then she simply begins to have heavy periods, during which the fertilized egg is expelled along with the blood.

Preparation

At the first appointment, the gynecologist explains to the woman all the contraindications, risks, possible complications and how a medical abortion is done in general terms, as well as what to expect after it.

Laboratory and instrumental diagnostics

Before taking this step and deciding on a medical, vacuum or other type of abortion, a woman must undergo a fairly large number of studies:

General (clinical) blood test , urine, (human chorionic gonadotropin), the level of which in the early stages is evidence of pregnancy. An ECG test is also taken for syphilis (RW).
Ultrasound . During an ultrasound examination, the presence of a fertilized egg in the uterus is confirmed, ectopic pregnancy, as well as tumor formations of the uterus and ovaries are excluded.
Examination by highly specialized specialists . Their consultation is necessary if a woman has any serious illnesses. It may also be necessary to adjust the intake of medications regularly taken by the patient in order for the drugs for medical termination of a developing pregnancy to be effective.
Checking the blood coagulation system . For this purpose, a coagulogram is usually prescribed, because if the blood does not clot well, then severe bleeding may occur after a medical termination of pregnancy.

Direct preparation for abortion

If during a medical examination and laboratory diagnostic examination no contraindications were identified, the doctor gives the following recommendations:

For a week, eliminate alcohol, smoking, taking anticoagulants and some other drugs.
On the day of taking the first dose of the drug, food should be easily digestible.
For the entire period of the abortion (3-6 days), care should be taken to ensure that if the woman’s condition worsens, someone will take care of her and run the household.

How is a medical abortion performed?

How is a medical abortion performed in a private or public clinic?

The procedure takes place in 3 stages:

At the doctor's office.
At home.
Follow-up visit to the doctor.

In the doctor's office, a woman who decides to have a medical abortion takes 3 tablets of mifepristone (600 mg) in the presence of a gynecologist, and then remains under his supervision for 2 hours.

Usually, before sending the patient home, the doctor gives her misoprostol tablets containing prostaglandin, leaves her his contact information and schedules the next visit to the clinic. This is done because he needs to observe how the woman’s abortion proceeds, whether the medications have the desired effect, and whether possible complications develop.

At home, after 1.5-2 days, the patient takes 2 tablets of misoprostol (400 mcg), which increases contraction of the uterine muscles. During the period of termination of pregnancy, some women experience severe pain. In this case, you should use medications to relieve pain.

How many days can a medical abortion last? On average, up to 6-7 days. It is at this time that blood loss is most significant and discharge is abundant.

A follow-up examination is scheduled on days 3 and 7-14. If, according to ultrasound and hCG analysis, the pregnancy has persisted, vacuum aspiration or classic curettage is performed.

What to do after a medical abortion

If a woman who has recently given birth had a medical abortion, until how many weeks can she breastfeed? According to most experts, you need to refrain from breastfeeding for 2 weeks, because the drugs used for medical abortion pass into breast milk, and their effect on the baby’s body has not been studied.

In general, the following recommendations should be followed:

Avoid strenuous physical activity and heavy lifting during bleeding.
For the first month after a medical abortion, in case of menstruation, use only pads and temporarily abandon tampons and menstrual trays.
During the entire period of vaginal discharge, you should not take a bath, go to the pool, etc.
Until how many weeks is sexual rest indicated? Sex after a medical abortion should be postponed for 3 weeks - 1 month. After termination, a new pregnancy can occur immediately with the resumption of sexual activity. Therefore, it is important to use.

It is impossible to predict how the reproductive system will behave after a medical termination of pregnancy has been performed: for some, during the next menstruation, the chest and lower abdomen hurt more than usual, for others, menstruation lengthens, etc.

In general, changes in the cycle are rarely observed, and if the abortion took place without complications, then the pattern of blood discharge during menstruation after it is the same as it was before the medical termination of pregnancy.

Complications

Although medical abortion is considered the least dangerous procedure, it can lead to a number of complications:

Failed abortion . This condition occurs if the procedure is performed for more than 6 weeks, as well as when taking medications that reduce the effectiveness of mifepristone.
Incomplete abortion . In this case, fragments of the fertilized egg remain inside the uterus, which can lead to various negative consequences, including death. An incomplete abortion can be suspected when bleeding suddenly stops, when a fragment of the fertilized egg clogs the cervical canal, as well as when there is a sharp increase in discharge during termination of pregnancy with the help of medications.
Failure in the hormonal system . Pregnancy is a hormonal change in the body. Therefore, even in the early stages, its interruption causes a failure of this system, which can be perceived by the body as a stressful state. For example, as a result of this, after an abortion performed with the help of medications, breast pain may occur, menstruation may be disrupted, or chronic diseases may worsen.
Complications associated with taking medications . After taking medications during a medical abortion, nausea, vomiting, diarrhea, stomach pain, headaches, fever, general weakness, and hot flashes occur. Dizziness, a sharp drop in blood pressure, loss of consciousness, and allergic reactions are also possible.
Uterine bleeding . Heavy bleeding can lead to significant blood loss, including loss of consciousness. Therefore, if bleeding at home during a medical abortion increases and exceeds the expected volume of blood released, you should immediately contact your doctor.

Can a placental polyp occur after a medical abortion? Unfortunately, yes, if all particles of the fertilized egg have not been removed.

How to avoid complications

To avoid complications, including the appearance of a placental polyp and excessive bleeding, you should undergo a thorough examination on the eve of medical termination of pregnancy. At the same time, there is no need to hide the facts of the use of any drugs, the presence of a placental polyp after a previous medical abortion, as well as serious diseases that may become a contraindication to the procedure.

The decision to terminate a pregnancy by medication or any other method should be weighed, taking into account all the pros and cons, and not made based on emotions. It is also important to take into account the possible psychological consequences.

Pros and cons of medical abortion

Obvious advantages compared to other types of abortion:

minimal trauma to the walls of the uterus;
abortion can be performed already from the first or second day of a missed period;
rapid recovery;
when carried out early, the effectiveness is 95%.

Possible disadvantages of the procedure:

high risk of bleeding;
preservation of pregnancy in 5-22% of cases (depending on the duration of pregnancy);
a large number of contraindications.

What is better for a placental polyp: medical abortion or curettage? In this case, curettage, because during this procedure it will be removed.

Medical termination of pregnancy is not a method of birth control - there are contraceptive methods for this. However, if certain circumstances arise as a result of which a woman decides to have an abortion, this method will be the most gentle. To minimize the risk of possible complications, you must undergo an examination and follow all doctor’s recommendations.

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